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Case 18 - Neuroprotectionduring surgical clip ligation of cerebral aneurysms

from Section I - Neuroanesthesia

Published online by Cambridge University Press:  03 May 2011

George A. Mashour
Affiliation:
University of Michigan
Ehab Farag
Affiliation:
Cleveland Clinic
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Summary

This chapter discusses the different strategies of neuroprotection applied to prevent ischemic damage to the brain during surgical clip ligation of cerebral aneurysms. It presents a case study of a 44-year-old male presented to hospital with acute subarachnoid hemorrhage (SAH); diagnostic cerebral angiogram was performed emergently that demonstrated an anterior communicating artery (ACOM) aneurysm. The ACOM artery aneurysm was deemed to be the cause of the SAH based on its morphology and the distribution of blood in the subarachnoid space. An interdisciplinary approach to the management of cerebrovascular disease is necessary for optimal patient outcome. Another method that has been reported to have some benefit in case of an unforeseen hemorrhage during clip ligation of a cerebral aneurysm is the use of adenosine to induce temporary cardiac arrest. Larger multicenter studies and more translational research are needed to demonstrate the efficacy of currently employed cerebral protective measures.
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Publisher: Cambridge University Press
Print publication year: 2011

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